The NHS is not fit for purpose

The Institute of Economic Affairs has published a new survey report, Sixty Years On: Who Cares for the NHS?, by Dr Helen Evans, Director of Nurses for Reform.

Containing a series of devastating blows to the NHS, the report shows that when speaking off the record a substantial majority of Britain's health elite no longer believe in nationalised healthcare. Instead, an overwhelming majority accept a much greater role for private provision - including private hospitals, clinics, GP services and dentists.

While the NHS is now charged with being ‘inequitable’, ‘two tier’, ‘rationed’ and ‘costly’, a majority also believe it is too ‘monopolistic’ and want to see a much greater role for private funding arrangements. Looking at private funding versus the state, an overwhelming majority of the respondents surveyed (65%) believe that because people's healthcare is unpredictable, some of its costs will increasingly have to be covered by private sources: "government arrangements such as taxation cannot do it all".

One of the most telling responses to the survey was a question about statutory restrictions on advertising. An overwhelming majority of the sample regarded Treasury Ministers as having the most to gain from the statutory restrictions on advertising because it promotes consumer ignorance. The banning of advertising of pharmaceutical products is perceived as a measure designed to keep patients in the dark so that they do not demand expensive drugs.

Overall, the results show that the world has dramatically moved on from the 1940s. As people's expectations increasingly outpace what the state can deliver, behind the scenes, opinion formers are starting to seriously consider market alternatives. Already, in many of their minds, the NHS is dead.

While in 1948 the NHS promised to provide "all medical, dental and nursing care", today some 25 million people are again going private for various forms of healthcare. 6.5 million people have private medical insurance. 6 million have private health cash plans. 8 million people pay privately for complementary treatments. More than 250,000 privately self-fund each year for private acute surgery, and many millions more pay privately towards long-term care. This is not to mention a whole raft of other NHS services - such as NHS dentistry - that are collapsing before our eyes.

If, as looks likely, the Government now allows private top-ups for medicines and treatments without precluding people from the NHS, they will only do so because they are playing catch up with what the public have long come to accept as reality. The NHS is no longer a dearly loved British institution. It is a nationalised embarrassment.